Pathology - Cairns - Cardiovascular

Question 1

Functions of endothelial cells include all of the following EXCEPT:
A) Formation of von-Willebrand factor
B) Formation of collegan and proteoglycans
C) Formation of IL1, IL6, IL8
D) Formation of histamine
E) Oxidation of LDL

Answer 1

D

Question 2

Response to vascular injury is characterised by:
A) Smooth muscle cells migration from media to adventitia
B) Reduced synthesis of ECM
C) Shift from contractile to proliferative-synthetic phenotype
D) Intimal thinning
E) Reduced healing response

Answer 2

C

Not D because there is intimal THICKENING.

Question 3

Atheromatous plaque has all of the following features EXCEPT:
A) Covering fibrous cap
B) Lipid core within the media
C) Greater involvement of the abdominal aorta than the thoracic aorta
D) Eccentric lesions rather than circumferential lesions
E) Intracellular and extracellular deposits

Answer 3

B. It is within the intima.

Question 4

Major risk factors for atherosclerosis include all of the following EXCEPT:
A) Obesity
B) Hyperlipidaemia
C) Diabetes
D) Smoking
E) Hypertension

Answer 4

A

Question 5

The most common cause of secondary hypertension is:
A) Renal disease
B) Phaechromocytoma
C) Coarctation of the aorta
D) Pregnancy
E) Stress

Answer 5

A

Question 6

Concerning the pathogenesis of essential hypertension:
A) Genetic factors are not important
B) Single-gene disorders are a major factor
C) Stress is not thought to be a relevant environmental factor
D) Defects in renal sodium homeostasis is a favoured hypothesis
E) Decreased sodium excretion results in reduced circulating fluid volume

Answer 6

D

Question 7

Concerning aneurysms:
A) Aneurysms most commonly occur in the peripheral vasculature
B) The haematoma within a false aneurysm does not communicate with the vascular space
C) Mycotic aneurysms are always true aneurysms
D) Morphology of the aneurysms is a good indicator of pathogenesis
E) Atherosclerosis is the most common cause of aneurysms

Answer 7

E

Question 8

Abdominal aortic aneurysms:
A) Cause 90% mortality during emergency surgery for rupture
B) Most commonly occur above the renal arteries
C) Uncommonly contain mural thrombus
D) Have 2% risk per year of rupture if less than 4cm diametre
E) Have a 50% risk per year of rupture if greater than 5cm diametre

Answer 8

Cairns says D but Robbins says that risk of rupture is 1% per year if 4-5cm diameter.

Question 9

Concerning aortic dissection:
A) Dissection is commonly associated with marked dilation of the aorta
B) Hypertension is an important causative factor in 50%
C) Dissection is most common in areas of extensive atherosclerosis
D) The most common cause of death is valve disruption
E) The most frequent pre-existing history is cystic medial degeneration

Answer 9

E (see pocket companion, 8th ed, p.269)

Question 10

Concerning venous thrombosis:
A) Genetic hypercoagulability syndromes are associated in 90% of cases
B) Deep pelvic veins account for 90% of cases
C) Appendicitis may lead to portal vein thrombosis
D) Migratory thrombophlebitis is a complication of pregnancy
E) Phlegmasia alba dolens is commonly associated with paraneoplastic syndrome

Answer 10

C

Question 11

Concerning congestive heart failure:
A) There is a 50% 5-yr mortality rate
B) The most common cause is valvular disease
C) Venous stasis is an uncommon finding
D) The heart is able to compensate by myocardial hyperplasia
E) The Frank-Starling mechanism is of little importance

Answer 11

A

Question 12

Concerning cardiac hypertrophy in response to cardiac failure:
A) Hypertrophy may occur as a result of hyperthyroidism
B) Hyperplasia may occur if hypertrophy is maximal
C) Pressure hypertrophy is characterised by normal or reduced cavity diameter
D) Volume hypertrophy may be associated with decreased wall thickness
E) Patients with severe aortic regurgitation usually have a normal sized heart

Answer 12

C

Question 13

The following are features of right-sided heart failure EXCEPT:
A) Cardiac cirrhosis
B) Peripheral oedema
C) Pericardial effusion
D) Facial oedema
E) Anasarca

Answer 13

D

Question 14

Concerning atheromatous plaque in coronary arteries:
A) Most commonly, a single artery is involved
B) Most patients with symptomatic IHD have lesions causing >75% stenosis
C) Most clinically important plaques are distally located in the coronary arteries
D) Acute coronary syndromes usually occur as a result of stable plaque
E) Plaque causing greater than 95% stenosis is most likely to undergo acute change

Answer 14

B

Question 15

Concerning IHD:
A) Death rate in the US from IHD has fallen by one half since 1980
B) Stable angina results from fixed coronary lesion
C) Unstable angina is characterised by complete obstruction of the artery
D) Vasoconstriction can result from increased release of NO
E) Thrombus is a poor activator of growth-related signals in muscle cells

Answer 15

B
Death rate has fallen by one half since 1963
Vasoconstriction can result from DECREASED release of NO
Thrombus is an activator of growth-related signals

Question 16

Myocardial infarction:
A) Is most common over the age of 65 years
B) Is less likely in post menopausal women due to reduced oestrogen
C) Is caused by plaque thrombosis in 60% of cases
D) Is caused by vasospasm in 40% of cases
E) Is more common in men except in the >85 years age group

Answer 16

A

Question 17

Concerning response to myocardial ischaemia:
A) Loss of contractility occurs within 60 seconds
B) Ischaemia lasting more than 10 minutes results in irreversible injury
C) ATP is reduced to 50% of normal in 30 minutes
D) Coagulative necrosis is more important than apoptosis
E) Irreversible injury initially occurs immediately adjacent to the occluded coronary artery.

Answer 17

D
Ischaemia lasting 20-40 minutes results in irreversible injury
ATP is reduced to 50% of normal in 10 minutes
Irreversible injury initially occurs in the subendocardial region

Question 18

Concerning location of coronary artery stenoses:
A) 90% are in the left anterior descending
B) 30-40% are in the RCA
C) Occlusion of the RCA results in infarction of the LV anterior wall and anterior part of the septum
D) 5% are in the left circumflex
E) Occlusion of the left circumflex results in infarction of the infero-posterior wall of the LV and the posterior septum

Answer 18

B

Occlusion of the RCA results in infarction of the LV posterior wall and posterior part of the septum